A Japanese mother struggling with depression strangled her five-year-old son at home before stabbing herself to death near Bukit Timah Nature Reserve in Singapore, a court's inquiry has found.

The boy was autistic and was also suffering from attention deficit hyperactivity disorder (ADHD). He was doing poorly in school, the inquiry added.

Unable to cope with work and caring for her two sons, Nami Ogata, 41, who first saw a psychiatrist and was on anti-depressants, left a suicide note addressed to her husband, apologizing for her actions and asking him to take care of their younger son.

She then drove to Lorong Sesuai to take her own life, bringing the dead boy's body along.

State Coroner Kamala Ponnampalam ruled Nami's death to be a "deliberate act of suicide" and her son's death to be an "unlawful killing at the hands of his mother" in her findings, which were made available on Monday.

Depressed, depression, anxiety
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What she told her psychiatrist

The findings state that the depressed mother had sought medical attention for her low mood and anxiety, and had told a psychiatrist about her suicidal thoughts and feelings of depression at least three days before the fatal incident on Nov 14, 2019.

The mother of two told the doctor she had been anxious for the past few months and that she was barely sleeping. She had also experienced the loss of appetite, weight, and hair, and had palpitations for about a week.

She also told the psychiatrist she was stressed about her son Sotaro, without revealing the exact reasons, the state coroner found.

Nami had then been immediately referred to the emergency medicine department at Singapore General Hospital, where she denied being actively suicidal but said she had been feeling depressed for a year.

She left behind her husband and their younger son.

But in two suicide notes, left for her brother in Japan and her husband, Nami told her husband that she was depressed and about to take their son with her, and that the panic attacks she was suffering "were too much".

Do not ignore depression

Depression and mental health problems are counted among some of the most vulnerable diseases worldwide today. According to the World Health Organisation, more than 264 million people of all ages suffer from depression globally.

Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school, and in the family. At its worst, depression can lead to suicide. Close to 800 000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds.

world health organisation
world health organisation

Thankfully, prevention programmes have been shown to reduce depression to a much larger extent. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive thinking in children and adolescents. Interventions for parents of children with behavioral problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for the elderly can also be effective in depression prevention. In addition, Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication.

WHO has developed brief psychological intervention manuals for depression that may be delivered by lay workers. An example is Problem Management Plus, which describes the use of behavioral activation, relaxation training, problem-solving treatment, and strengthening social support. Moreover, the manual Group Interpersonal Therapy (IPT) for Depression describes group treatment of depression.